Possibilities of using autologous platelet-rich plasma (PRP) in the treatment of chronic non-healing wounds

Introduction. The problem of pressure ulcers remains relevant despite advances in modern medicine. They are a serious medical, social and economic problem, significantly impacting quality of life.

The objective was to evaluate the effectiveness of PRP in patients with pressure ulcers.

Methods and materials. This article presents a randomized controlled trial (n=100). Wound defect status was assessed using the Bates-Jensen Wound Assessment Scale (BWAT). The evaluation criteria were wound duration, wound defect area, proportion of patients with a completely healed wound surface and with an incompletely healed wound surface, percentage of healed wound area, time to complete healing, wound closure rate, complication rate, total epithelialized area and scar quality after healing.

Results. The groups were clinically comparable in terms of age, gender, location, pressure ulcer severity, initial wound area and wound defect duration (p>0.05 for all parameters). PRP therapy significantly accelerated healing: average healing time was 4.5±0.3 weeks compared to 6.6±0.5 weeks in the control group (p=0.001). Complete healing was achieved in 60 % of patients in the PRP group compared to 36 % in the control group (p=0.016; OR=2.67). The wound closure rate in the PRP group was 4.73±2.51 cm2/week compared to 1.14±2.02 cm2/week in the control one (p<0.001). The median wound area reduction was 100 % in the PRP group compared to 19.5 % in the control (p<0.001). The complication rate was significantly lower with PRP: no complications in 55 % compared to 30 % (p=0.009).

Conclusion. PRP therapy significantly accelerates healing. Complete healing was achieved in 60 % of patients in the PRP group compared to 36 % in the control group (p=0.016; OR=2.67). No cases in the PRP group showed an increase in wound size at the end of treatment, compared to 30 % in the control group (p<0.001). Complication rates were significantly lower with PRP: no complications in 55 % compared to 30 % (p=0.009); combined necrosis and infection in 6 % compared to 30 % (OR=0.15). Scar quality after healing was better in the PRP group.

1. Somov N. O. Bedsores: modern approaches to prevention and treatment // Medical business. 2023;(7–8):52–53. (In Russ.).

2. Pasechnik I. N., Novikova T. V. Bedsores: new approaches to treatment // Medical business. 2022;(4):38–43. (In Russ.).

3. Senetsky S. V., Sushinsky V. E., Malkevich V. T. Pressure sores in medical practice: the relevance of the problem in modern society, risk scales of development, prevention, diagnosis // Recipe. 2023;26(2):208–220. https://doi.org/10.34883/PI.2023.26.2.012. EDN: CMVXID. (In Russ.).

4. Osmanov E. G. O., Shulutko A.M., Khmyrova S.E. and others. Possibilities of high-frequency electrical stimulation in the treatment of pressure sores // Wounds and wound infections. The journal named after Professor B. M. Kostyuchenka. 2024;(1):42–47. (In Russ.).

5. Osmanov E. G., Shulutko A.M., Yakovlev A. A. Conservative treatment of decubital ulcers using physical methods of exposure (review) // General resuscitation. 2022;(2):83–88. (In Russ.).

6. Umarov B. Ya. Immunological aspects and modern approaches to the treatment of long-term non-healing wounds: diagnosis, therapy and prevention of complications // Bulletin of the Association of Pulmonologists of Central Asia. 2025;8(3):37–40. (In Russ.).

7. Wang Y., Liu B., Pi Y. Risk factors for diabetic foot ulcers mortality and novel negative pressure combined with platelet-rich plasma therapy in the treatment of diabetic foot ulcers // Front Pharmacol. 2022;13:1051299. https://doi.org/10.3389/fphar.2022.1051299. PMID: 36588684. PMCID: PMC9800930.

8. Perussolo J., Calciolari E., Dereka X.et al. Platelet-rich plasma and plasma rich in growth factors in extra-oral wound care // Periodontol 2000. 2025;97(1):320–341. https://doi.org/10.1111/prd.12572. PMID: 39056422. PMCID: PMC11808476.

9. Kurian S., Moore Z., Patton D., George S. The incidence of pressure ulcers in surgical patients: a systematic review // Int Wound J. 2025;22(8):e70738. https://doi.org/10.1111/iwj.70738. PMID: 40825923. PMCID: PMC12360911.

10. Utility model patent RU 174784 U1. Test tube syringe for producing blood plasma with a high platelet content: No. 2016142489: application 28.10.2016: published 02.11.2017 / Bashkatov Yu. G.; patent holder: Bashkatov Yu. G. [Russian Federation, A61M 1/00]. (In Russ.).

11. Utility model patent RU 176780 U1. A medical device for producing blood plasma with a high platelet content: No. 2017118118: application dated 05/24/2017: published on 01/29/2018 / Bashkatov Yu. G.; patent holder: BIONET-PLUS LLC [Russian Federation, A61M 1/00]. (In Russ.).

12. Patent for invention RU 2747943 C2. A medical device for producing blood plasma with a high platelet count: No. 2018113907: application 04/17/2018: published 05/17/2021 / Bashkatov Yu. G.; patent holder: BIONET-PLUS LLC [Russian Federation, A61B 5/15, A61J 1/05]. (In Russ.).